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All human being's ways of living, working and studying were significantly impacted by the COVID-19 in 2020. In China, the Ministry of Education reacted fast in ensuring that primary school students could learn online at home by promoting the Sky Class program from February 2020. Educators, parents, and students all faced the challenges of adapting to new online teaching and learning environments. In this small-scale case study, Sky Class's content and the participants' experiences, will be presented. Four primary school teachers and five primary school students and their parents participated in three-rounds of interviews sharing their perspectives and experiences of online learning. The study showed that the students gained more parental support and that they benefited from using multimedia functions, like replay, in their Sky Classes. However, the majority of participants reported that the students learnt less. By mapping the learning activities and themes from Sky Class against Cope and Kalantzis' e-learning ecologies, our study found that only ubiquitous learning and multimodal meaning were achieved. We suggest the reason may be that high cognitive learning was not achieved due to less teachers' supervision, lack of interaction, delayed feedback, shorter learning times and communication. In conclusion, innovative pedagogies, which can foster different types of learning from the e-learning ecologies may overcome the negative aspects reported about Sky Class. Further research is required for implementing online technology as a catalyst for educational change.

Tozorakimab is a high‐affinity human immunoglobulin G1 monoclonal antibody that neutralizes interleukin (IL)‐33, an IL‐1 family cytokine. This phase 1, single‐center, randomized, double‐blind, placebo‐controlled, single ascending dose study (NCT05070312) evaluated tozorakimab in a healthy Chinese population. Outcomes included the characterization of the pharmacokinetic (PK) profile and immunogenicity of tozorakimab. Safety outcomes included treatment‐emergent adverse events (TEAEs) and clinical laboratory, electrocardiogram, and vital sign parameters. Healthy, non‐smoking, male, and female Chinese participants aged 18‐45 years with a body mass index 19‐24 kg/m2 were enrolled. In total, 36 participants across 2 cohorts of 18 participants were randomized 2:1 to receive a single subcutaneous dose of tozorakimab (300 mg [2 mL] or 600 mg [4 mL]) or matching placebo (2 or 4 mL). Tozorakimab showed dose‐dependent serum PK concentrations with an approximate monophasic distribution in serum over time and a maximum observed peak concentration of 20.1 and 33.7 μg/mL in the 300‐ and 600‐mg cohorts, respectively. No treatment‐emergent anti‐drug antibodies for tozorakimab were observed in any of the participants. There were no clinically relevant trends in the occurrence of TEAEs across the treatment groups. There were no clinically relevant trends over time in clinical laboratory (hematology, clinical chemistry, and urinalysis), electrocardiogram, or vital sign parameters in any treatment group. Overall, tozorakimab demonstrated dose‐dependent systemic exposure in healthy Chinese participants and was well tolerated, with no safety concerns identified in this study. [ABSTRACT FROM AUTHOR]

Listeria monocytogenes is an important foodborne pathogen with worldwide prevalence. Understanding the variability in the potential pathogenicity among strains of different subtypes is crucial for risk assessment. In this study, the growth, survival, and virulence characteristics of 16 L. monocytogenes strains isolated from imported meat in China (2018–2020) were investigated. The maximum specific growth rate (μmax) and lag phase (λ) were evaluated using the time-to-detection (TTD) method and the Baranyi model at different temperatures (25, 30, and 37 °C). Survival characteristics were determined by D-values and population reduction after exposure to heat (60, 62.5, and 65 °C) and acid (HCl, pH = 2.5, 3.5, and 4.5). The potential virulence was evaluated via adhesion and invasion to Caco-2 cells, motility, and lethality to Galleria mellonella. The potential pathogenicity was compared among strains of different lineages and subtypes. The results indicate that the lineage I strains exhibited a higher growth rate than the lineage II strains at three growth temperatures, particularly serotype 4b within lineage I. At all temperatures tested, serotypes 1/2a and 1/2b consistently demonstrated higher heat resistance than the other subtypes. No significant differences in the log reduction were observed between the lineage I and lineage II strains at pH 2.5, 3.5, and 4.5. However, the serotype 1/2c strains exhibited significantly low acid resistance at pH 2.5. In terms of virulence, the lineage I strains outperformed the lineage II strains. The invasion rate to Caco-2 cells and lethality to G. mellonella exhibited by the serotype 4b strains were higher than those observed in the other serotypes. This study provides meaningful insights into the growth, survival, and virulence of L. monocytogenes, offering valuable information for understanding the correlation between the pathogenicity and subtypes of L. monocytogenes. [ABSTRACT FROM AUTHOR]

Background: Puerperal infection (PI) is a severe threat to maternal health. The incidence and risk of PI should be accurately quantified and conveyed for prior decision-making. This study aims to assess the quality of the published literature on the epidemiology of PI, and synthesize them to identify the temporal trends and risk factors of PI occurring in Mainland China. Methods: This review was registered in PROSPERO (CRD42021267399). Putting a time frame on 2010 to March 2022, we searched Cochrane library, Embase, Google Scholar, MEDLINE, Web of Science, China biology medicine, China national knowledge infrastructure and Chinese medical current contents, and performed a meta-analysis and meta-regression to pool the incidence of PI and the effects of risk factors on PI. Results: A total of 49 eligible studies with 133,938 participants from 17 provinces were included. The pooled incidence of PI was 4.95% (95%CIs, 4.46–5.43), and there was a statistical association between the incidence of PI following caesarean section and the median year of data collection. Gestational hypertension (OR = 2.14), Gestational diabetes mellitus (OR = 1.82), primipara (OR = 0.81), genital tract inflammation (OR = 2.51), anemia during pregnancy (OR = 2.28), caesarean section (OR = 2.03), episiotomy (OR = 2.64), premature rupture of membrane (OR = 2.54), prolonged labor (OR = 1.32), placenta remnant (OR = 2.59) and postpartum hemorrhage (OR = 2.43) have significant association with PI. Conclusions: Maternal infection remains a crucial complication during puerperium in Mainland China, which showed a nationwide temporal rising following caesarean section in the past decade. The opportunity to prevent unnecessary PI exists in several simple but necessary measures and it's urgent for clinicians and policymakers to focus joint efforts on promoting the bundle of evidence-based practices. [ABSTRACT FROM AUTHOR]

Understanding the linkages between aboveground and belowground ecosystems is important for explaining the variation in soil organisms with plant communities on a spatiotemporal scale. Here, soil nematode communities were investigated across three successional stages (early, mid, and late) in two contrasting forests at low and high latitudes in China. We found that forest succession affected the relative abundance of some nematode trophic groups, whereas it did not alter the total nematode abundance in the two forests. Nonmetric multidimensional scaling analysis showed that nematode community composition changed significantly from the early and mid‐stages to the late stage. The mantel analysis showed that total soil P at low latitude and litter C:N ratio at high latitude were more closely related to the variation in nematode community during forest succession, respectively. Total nematode diversity increased marginally with forest succession at low latitude, but first increased and then decreased with forest succession at high latitude. Interestingly, total nematode diversity was related to plant‐feeding nematode diversity during forest succession in both the forests. In addition, structural equation models showed that the diversity of different nematode trophic groups was directly affected by forest succession and indirectly affected by the quantity of soil resources and the quality of soil and litter. More importantly, forest succession drives total nematode diversity by directly affecting plant‐feeding nematode diversity. Collectively, forest succession alters the diversity and increases the dissimilarity of soil nematode communities. However, changes in soil and litter properties during forest succession at different latitudes differentially influence nematode communities. [ABSTRACT FROM AUTHOR]

Qixiang is a unique sacrificial culture created by the Han army eight banners in northeast China. This culture not only has elements such as shamanism and Han people burning incense, but also has military sacrificial elements. This paper argues that Qixiang is the evolution and legacy of Maji, a military sacrificial ritual in ancient China. The Han military banner people in the Qing Dynasty took Maji as the main body, combined the Manchu Shamanism with the Han incense burning, and created a cultural symbol representing their own ethnic group. At present, the study of Qixiang not only helps to understand the complexity of the development and evolution of Manchu shamanism, but also helps to reveal the ethnic identity of Han bannermen under the Eight Banners system of the Qing Dynasty. [ABSTRACT FROM AUTHOR]

China has abundant germplasm resources of pomegranate. Previous studies have analyzed the fruit quality of the cultivated and wild pomegranates collected from different regions of China. In this study, 45 pomegranate cultivars from Yicheng, Shandong province, China were used as materials. Principal component and cluster analysis was performed based on 18 fruit quality traits. There were significant differences in 18 fruit traits among 45 pomegranate cultivars. Nine principal components (PCs) were extracted by principal component analysis, and the cumulative variance contribution rate was 84.9%. PC1 and PC2 represented 20.9%, 14.3% of total variance respectively. The former was highly positively contributed by total flavonoid and phenolic content of juice, pericarp (FCJ, PCJ, FCP and PCP), and Vitamin C content of juice, while the latter was highly positively correlated with proanthocyanidins and total flavonoid content of seeds (PAS and FCS) and titratable acid content. According to the comprehensive scores, Yushiliu, Gangliu, Mantianhongsuan, Tianlvzi, Xinjianghongpi, Huaiyuanerbenzi, Xiaoqingpi, Damaya, Yichengheshunzhuangwuci, Taishanhong ranked as the top ten. The 45 pomegranate cultivars were clustered into four categories according to 18 fruit quality indicators, each group had unique characteristics. Most cultivars of group III had higher PCJ and proanthocyanidins content of pericarp, while most members of group Ⅳ had higher total anthocyanin contents, FCP and PCP, which suggested that the two groups were rich in functional substances and can be used for further processing. Therefore, the results would provide a method to comprehensively evaluate different cultivars and provide a reference for agricultural cultivation, industrial utilization and breeding. [ABSTRACT FROM AUTHOR]

Background: Appropriate lessons and formalized training concerning emergency medicine is becoming increasingly important in undergraduate medical education. There is an urgent need to evaluate undergraduate emergency medicine education of students enrolled on the 8-year Doctor of Medicine degree programs nationwide in China with the aim that the data extracted could ultimately be used to help develop a standardized emergency medicine curriculum in China. Objectives: The aim of the study is to accurately describe emergency medicine education of 8-year Doctor of Medicine program in China, including emergency medicine classes, clinical practice in emergency medicine department, and expectations toward emergency medicine education. Methods: An online questionnaire was distributed to all the medical students of 8-year Doctor of Medicine program who have attended emergency medicine education in 14 medical schools in China. Participation in the survey was voluntary and anonymized. Results: In total, 529 valid responses were collected. There was a clear difference between students with a career aspiration in emergency medicine and those without. Comparing to countries that have an established emergency medicine curriculum, shortage of classroom hours and clinical practice time is a major cause of unsatisfactory educational outcomes in China. A detailed uniform emergency medicine curriculum that outlines exact requirements for medical students is required as well. Conclusion: A consolidated syllabus and curriculum should be compiled by all the medical schools with the 8-year integrated Doctor of Medicine degree program in China. The specific diseases and skills that should be covered in emergency medical education remain up to debate. [ABSTRACT FROM AUTHOR]

Biological soil crusts (BSCs) are an integration of external photoautotrophs and internal heterotrophic communities. Sand burial is a ubiquitous disturbance that affects the biodiversity and ecological function of BSCs, but little is known about the influence of sand burial on microbial communities in arid sandy deserts. Here, based on a long-term field experiment and utilizing high-throughput sequencing, we assessed the influence of sand burial on bacterial and fungal communities inhabiting two typical successional stages of BSCs (cyanobacterial crusts for early successional stage and mixed crusts for late successional stage) at the three-sand buried depth (0, 0.5, and 10 mm) in the Tengger Desert, Northern China. We found that the diversity, abundance, and composition of the bacterial and fungal communities were all altered by the sand burial treatment. Different indicator taxa were identified in unburied and buried (shallow and deep) BSCs. Changes in soil properties caused by sand burial have been suggested as a possible cause of changes in the bacterial and fungal community composition in BSCs. [ABSTRACT FROM AUTHOR]

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This study analyzed genomic data of 4643 strains of carbapenemase-carrying Klebsiella pneumoniae (KPN) in China by using the Kleborate software package. The data showed rich diversity in carbapenemase-carrying KPN genomes, which contain not only 152 sequence types but also 90 capsular serotypes. In 2013, the transfer of carbapenemase to hypervirulent Klebsiella pneumoniae (HvKP) of KL1 and KL2 occurred, and since 2014, the propagation of carbapenemase into mammals, poultry, and insects has been detected. The ST11 capsular serotype had a reversal of the prevalence of KL47 and KL64 in 2016, with KL64 replacing KL47 as the dominant serotype. Colibactin is a very suitable indicator to differentiate KL1-type HvKP and classic Klebsiella pneumoniae. The most prevalent yersiniabactin of KL1 is ybt1 ICEKp10, and that of ST11 carbapenem-resistant KPN(ST11-CRKP) is ybt9 ICEKp3. The virulence genes of KL1 carbapenem-resistant hypervirulent KPN (KL1-CRHvKP), as well as ST65- and ST86-type KL2-CRHvKP, were not lost after carbapenemase was obtained. [ABSTRACT FROM AUTHOR]

The usage of pesticides is deemed essential to ensure crop production for global food security. Conventional chemical pesticides have significant effects on ecosystems. Nanopesticides are increasingly considered an emerging alternative due to their higher efficiency and lower environmental impacts. However, large knowledge gaps exist in the public perceptions and willingness-to-pay (WTP) for nanopesticides. Thus, we conducted a regional survey of pesticide users and food consumers on perceptions and WTP for nanopesticides across China. We found that 97.4% pesticide users were willing to pay for nanopesticides, with a main price from 25% to 40% higher than for conventional pesticides. Experience with applying pesticides, income, familiarity with and attitude toward nanopesticides, and trust in industries were significant determinants of WTP. Although the public were not familiar with nanopesticides, they had positive attitudes toward their future development and supported labeling nanoscale ingredients on products. Pesticide users presented high trust levels in governments and industries, while 34% of food consumers neutrally or distrusted industries in selling and production. This study highlights the socioeconomic and technological aspects of nanopesticides, which could provide guidance for industries to develop market strategies and for governments to design relevant regulation policies effectively, contributing to crop yield improvement and sustainable agriculture. [ABSTRACT FROM AUTHOR]

Background: Negative emotions among employees have become a public problem that increase the risk of developing the disease and accelerate its progression. This study aimed to investigate the status and influencing factors of negative emotions among young employees in center of disease control and prevention.Methods: Participants included 6099 employees aged 40 or below in center of disease control and prevention (CDC) of 32 province of China were interviewed by online questionnaire survey. The emotional conditions of anxiety and depression, and their influencing factors were analyzed.Results: A total of 5353 valid questionnaires were collected with the recovery rate of 87.77%. 2871 cases of young employees had different degrees of negative emotions at work, accounting for about 53.60%. Regression analysis showed that gender, professional title, educational level, job satisfaction, chronic diseases, daily sleep duration, average weekly overtime, physical activity time, and sugary beverage intake were the influencing factors of negative emotions (P < 0.05). Male, primary and below, never working overtime and daily physical activity time more than 30 min were protective factors for negative emotions (OR vale were 0.79, 0.68, 0.39 and 0.63, respectively, P < 0.05). Bachelor degree or above, poor job satisfaction, chronic disease, daily sleep duration less than 8 h and drinking one to three sugary drinks a week were the risk factors for negative emotion (OR vale were1.21, 4.32, 2.16, 2.75 and 1.20, respectively, P < 0.05).Conclusion: Due to the influence of work pressure, lifestyle, chronic diseases and other factors, young employees in CDC have a certain degree of negative emotions at work, which should be paid enough attention. Meanwhile, corresponding measures should be taken according to the influencing factors to reduce the occurrence of negative emotions. [ABSTRACT FROM AUTHOR]

Background: Stroke patients may suffer from a variety of symptoms which can result in sleep disturbance and post-stroke depression (PSD). Whereas, resilience can alleviate sleep disturbance and help maintain well-being after stroke. Objective: The aim of this study is to explore whether resilience plays a mediating role in the relationship between sleep disturbance and PSD of stroke patients in China. Methods: A cross-sectional study with a multi-stage sampling was carried out in Liaoning Rehabilitation Center and the Third People's Hospital of Chongqing in China from May to September 2019. A total of 353 stroke patients were enrolled in this study. Structural equation model (SEM) was used to test the mediating effect of resilience on the relationship between sleep disturbance and PSD. Results: The prevalence of PSD of stroke patients was 34.56%. Sleep disturbance contributed most to the variance of PSD and had a significantly positive association with PSD among stroke patients (P < 0.01). Resilience was negatively associated with PSD, and acted as a mediator between sleep disturbance and PSD (a * b = 0.201, BCa 95% CI: 0.156~0.254). Conclusions: The prevalence of PSD was high among the Chinese stroke patients. Sleep disturbance was highly associated with PSD, resulting in the increased risk of PSD. Furthermore, resilience has a mediating effect on the relationship between sleep disturbance and PSD, and could reduce the negative effect of sleep disturbance on the development of PSD. [ABSTRACT FROM AUTHOR]

Purpose: Although several trials have confirmed the treatment efficacy of induction chemotherapy followed by concurrent chemoradiotherapy (CCRT) in locoregionally advanced nasopharyngeal carcinoma (NPC) from endemic area of China, little is known about the best regime for induction chemotherapy in non-endemic region. This study compared the treatment effect of Gemcitabine and cisplatin (GP) versus docetaxel and cisplatin (TP) followed by concurrent chemoradiotherapy in locoregionally advanced NPC from non-endemic area of China. Materials and methods: A total of 196 locoregionally advanced NPC patients were enrolled in this study, with 142 and 54 patients in TP and GP followed by concurrent chemoradiotherapy groups. The primary endpoint was treatment response of induction chemotherapy. The secondary endpoints included disease-free survival. The Kaplan–Meier method was used to evaluate the efficacy between treatment groups. Results: The median follow-up time was 45.5 months (range: 6–60.5 months). During induction chemotherapy course, GP contributed higher treatment response rate than TP (68.1% vs. 47.1%, p = 0.007). Patients in GP group had better DFS and LRFS than those in TP group (3-year and 5-year DFS, 86.8% and 82.5% vs. 71.7% and 68%, p = 0.036; 3-year and 5-year LRFS, 96.2% and 96.2% vs. 90.5% and 82.8%, p = 0.03). No significant difference of adverse events was observed between two treatment groups in the whole course. Conclusion: This study suggested that GP followed by CCRT was better than TP followed by CCRT in improving survival outcomes of locoregionally advanced NPC patients from non-endemic area of China. [ABSTRACT FROM AUTHOR]

Background The clinical outcomes for early-stage nasopharyngeal carcinoma (NPC) in northwest China were evaluated. Methods A retrospective study was performed from 69 patients with NPC patients treated with intensity-modulated radiation therapy (IMRT) with or without chemotherapy. Results Median follow-up was 34 months. World Health Organization (WHO) type II was the predominant histology (71%). All treatment failures occurred in T2N1 NPCs (14.5%), with metastasis the major reason. The 3-year overall survival (OS), local recurrence-free survival (LRFS), and distant metastasis-free survival (DMFS) were 93.3%, 94.1%, and 94.8% respectively. The 3-year survival rate for T2N1 and IMRT alone group were both significantly poorer than the T1N0, T2N0, and T1N1 groups and the chemoradiation group, respectively ( p < .05). N1 classification, T2N1 classification, and addition of chemoradiation were significant independent predictors ( p < .05). No grade IV toxicities were observed. Conclusion T2N1 classification is a unique subgroup with higher risk of distant metastasis. Improved outcomes of T2N1 NPC with predominantly WHO II histology after chemoradiation has not been reported. © 2013 Wiley Periodicals, Inc. Head Neck 36: 841-847, 2014 [ABSTRACT FROM AUTHOR]

: Xonghong Xiao and colleagues analyze the challenge of antimicrobial resistance in China. A government strategy to promote rational use of antimicrobials in health care reduced antibiotic sales and percentage of prescriptions for antimicrobials for both hospitalized patients and outpatients, and offers insights to shape future initiatives. Please see later in the article for the Editors' Summary [ABSTRACT FROM AUTHOR]

Previous studies have indicated maternal exposure to particles with aerodynamic diameter <2.5 μm (PM 2.5) is associated with preterm birth (PTB). However, no study has investigated this effect in pre-pregnancy impaired fasting glucose (IFG) women. This study aimed to differentiate the effects of maternal PM 2.5 exposure on PTB between pre-pregnancy IFG and normoglycemia women, and to further identify the susceptible window. This cohort study was conducted between January 2014 and December 2017 in 21 Chinese cities. All the recruited women received pre-pregnancy fasting serum glucose (FSG) tests and were followed up for their delivery outcomes. The PM 2.5 exposures were estimated by the daily air pollution concentrations of the nearby monitors. Women with FSG below 7.0 mmol/L were included in the analysis. We employed the Cox proportional hazards models to examine whether PM 2.5 exposure was associated with PTB. 237957 women were included and 7055 (3.0%) of them were pre-pregnancy IFG. During the entire pregnancy, we found 24.1% (HR = 1.241; 95% CI: 1.069, 1.439), 61.8% (HR = 1.618; 95% CI: 1.311, 1.997) and 18.6% (HR = 1.186; 95% CI: 1.004, 1.402) of increases in risk for all PTB, early PTB (20–33 gestational weeks) and late PTB (34–36 gestational weeks) among the pre-pregnancy IFG women, and 15.9% (HR = 1.159; 95% CI: 1.127, 1.192), 33.9% (HR = 1.339; 95% CI: 1.255, 1.430) and 13.2% (HR = 1.132; 95% CI: 1.098, 1.168) of increases in risk for all PTB, early PTB and late PTB among the normoglycemia women, with each 10 μg/m3 increment of PM 2.5 exposure, respectively. Furthermore, PM 2.5 exposure had the strongest effect on all PTB during trimester 1 (0–12 gestational weeks) among the pre-pregnancy IFG women, compared with the less strong effect during trimester 1 among the normoglycemia women. In conclusion, pre-pregnancy IFG increases the risk of PTB attributed to PM 2.5 , especially during trimester 1. Moreover, the effects of PM 2.5 are greater on early PTB than late PTB for both pre-pregnancy IFG and normoglycemia women. • The first study on association of PTB with PM2.5 in pre-pregnancy IFG women. • Pre-pregnancy IFG increases the risk of PTB attributed to ambient PM2.5. • Susceptible exposure windows for pre-pregnancy IFG women is the trimester 1. • Effects of PM2.5 are greater on early PTB than late PTB for pregnancy women. [ABSTRACT FROM AUTHOR]

Shiga toxin-producing Escherichia coli (STEC) and enteropathogenic Escherichia coli (EPEC) are foodborne pathogens that cause hemolytic uremic syndrome and fatal infant diarrhea, respectively, but the characterization of these bacteria from imported food in China are unknown. A total of 1577 food samples from various countries during 2015–2021 were screened for STEC and EPEC, and the obtained isolates were tested for antimicrobial resistance and whole genome sequencing analysis was performed. The prevalence of STEC and EPEC was 1.01% (16/1577) and 0.51% (8/1577), respectively. Antimicrobial resistances to tetracycline (8%), chloramphenicol (8%), ampicillin (4%), ceftazidime (4%), cefotaxime (4%), and trimethoprim-sulfamethoxazole (4%) were observed. The antimicrobial resistance phenotypes corresponded with genotypes for most strains, and some resistance genes were related to mobile genetic elements. All 16 STEC isolates were eae negative, two solely contained stx1 (stx1a or stx1c), 12 merely carried stx2 (stx2a, stx2d, or stx2e), and two had both stx1 and stx2 (stx1c + stx2b, stx1a + stx2a + stx2c). Although they were eae negative, several STEC isolates carried other adherence factors, such as iha (5/16), sab (1/16), and lpfA (8/16), and belonged to serotypes (O130:H11, O8:H19, and O100:H30) or STs (ST297, ST360), which have caused human infections. All the eight EPEC isolates were atypical EPEC; six serotypes and seven STs were found, and clinically relevant EPEC serotypes O26:H11, O103:H2, and O145:H28 were identified. Two STEC/ETEC (enterotoxigenic E. coli) hybrids and one EPEC/ETEC hybrid were observed, since they harbored sta1 and/or stb. The results revealed that food can act as a reservoir of STEC/EPEC with pathogenic potential, and had the potential ability to transfer antibiotic resistance and virulence genes. [ABSTRACT FROM AUTHOR]

• Archaeal community and functional structures were studied during BSC succession. • Archaeal diversity, abundance, and functional gene intensity were highest in the initial stage. • The dominant phyla of archaea were complementary in biogeochemical cycles. • C:N ratio was the mainly limited factor for archaeal diversity and function. • Archaea might serve as a pioneer species of microbial communities in BSC development. Archaea are major contributors to biogeochemical cycles and energy metabolism among soil microorganisms under extremely acidic and high-temperature conditions, however, the biodiversity and ecological function of archaea in biological soil crusts (BSCs) of desert ecosystems are not fully understood. Here, we used Illumina MiSeq sequencing and microbial functional gene array (GeoChip 5.0) to test the following hypotheses: (1) the composition and function related to biogeochemical cycles of the archaeal community would change significantly in the development process of BSCs; and (2) the key factors driving these changes may be soil biogeochemical properties. The results showed that the diversity, abundance, and functional potential of the archaeal community showed their highest levels in 5-year-old BSCs. The dominant phyla were Thaumarchaeota, Euryarchaeota, and an unclassified phylum in the archaeal community during BSC succession. The functional genes of the archaeal community were mainly involved in carbon (C) and nitrogen (N) cycles, and the functions of the three dominant phyla were complementary in these cycles. Moreover, redundancy analysis showed that soil biogeochemical properties were negatively related to the composition and function of the archaeal community during BSC succession, and the soil C:N ratio might be the major limiting factor. These results provided evidences for our hypotheses and revealed that the archaeal community played an important ecological role in the early development stage of BSCs, and might be pioneer species of soil microbial communities during BSC succession. [ABSTRACT FROM AUTHOR]

Apple is one of the largely grown fruits in China, and it suffers great economic losses caused by Penicillium expansum infection every year. In the present study, we ascertained the efficacy of Meyerozyma guilliermondii enhanced by 200 μmol/L methyl jasmonate (MeJA) in controlling the postharvest blue mold decay of apples and the possible mechanisms involved. The results demonstrated that the biological control ability of M. guilliermondii induced by MeJA in restraining P. expansum infection in apples. The efficacy of M. guilliermondii induced by MeJA significantly decreased the decay incidence and lesion diameter of apples. When treated with M. guilliermondii induced by MeJA, the decay incidence of apples was only 21.6%, while apples treated with M. guilliermondii was 42.4%. M. guilliermondii induced by MeJA also reduced the germ tube length, spore germination rate of P. expansum in PDB and colony diameter of P. expansum in PDA. The results also showed that antagonistic yeast induced by MeJA proliferated better in apple wounds and surface at 4 °C or 20 °C. Meanwhile, the activities of resistance-related peroxidase (POD), polyphenol oxidase (PPO), phenylalanine ammonia-lyase (PAL), Catalase (CAT), and the antibacterial substances of flavonoid contents, total phenolic content were all increased. The results manifested that M. guilliermondii induced by MeJA increased the expression levels of defense-related enzymes in apples. • M. guilliermondii induced by MeJA decreased blue mold decay of apples. • M. guilliermondii induced by MeJA colonized in apples steadily at 20 °C and 4 °C. • M. guilliermondii induced by MeJA decreased spore germination rate of P. expansum. • M. guilliermondii induced by MeJA increased PPO, POD, CAT, PAL activities of apples. • M. guilliermondii induced by MeJA increased the expression of PPO, POD, PAL, CAT. [ABSTRACT FROM AUTHOR]

• Fungal community diversity and abundance of BSCs increased during 60 years of succession. • Fungal functional gene diversity and abundance reached the highest level in 60-year-old BSCs. • Higher functional and compositional resilience were in 60-year-old BSCs. • At least 60 years might be needed for the steady state of BSCs in temperate desert. Development of community compositional and functional gene structure of fungi in biological soil crusts (BSCs) of different successional stages in the Tengger Desert, China, was assessed using Illumina MiSeq sequencing and GeoChip analysis, respectively. Fungal diversity and abundance significantly increased during 60 years of succession, and reached close to the highest level in the late BSC development, corresponding to those in natural habitats. Principal coordinate analysis showed that the BSC fungal communities in 60-year-old revegetation and natural vegetation clustered together, when compared with short-term revegetation. Furthermore, the diversity and relative abundance of fungal functional genes involved in biogeochemical cycling and stress response in dominant phyla reached the highest level after 60 years of BSC development, indicating that this period is an important landmark for fungal community and function. Higher functional and compositional resilience in 60-year-old BSCs implied a higher level of stability of the aggregated BSC ecosystem functions. Thus, the stability of BSC ecosystems could be estimated indirectly based on the development of fungal community, and at least 60 years might be needed for the steady state of BSCs in temperate desert zones without mechanical disturbance. [ABSTRACT FROM AUTHOR]

Developing the agriculture of Chinese materia medica (CMM) is an effective way to meet the market demand and conserve wild medicinal plant resources. However, blind introduction and homogeneous competition have hindered the sustainable development of CMM agriculture. To address this issue, the commonly used medicinal plants were ranked based on their frequency of clinical usage, geographical distribution range, economic value, and threatened status to set development priorities. Using 283,191 records of suitable producing regions, a county-level planting plan for 710 medicinal species in China were provided based on their development priority index. This study found that cultivating approximately four species per county and planting every species in 19 counties would be optimal. The proposed production regionalization for the commonly used medicinal plants in China can not only avoid blind introduction and homogeneous competition, but also (1) facilitate the large-scale production of CMM plants and reduce production costs, (2) help control the concentration of effective components in CMM raw materials, and (3) alleviate the imbalance between supply and demand in the market. The innovative approach of this study could also be applicable to other industrial crops and economic plants worldwide. [Display omitted] • The development priority for commonly used medicinal plants was assessed. • Innovative approach for production regionalization was applied to medicinal plants. • Circa four species per county and planting every species in 19 counties was suggested as the optimal plan. • Botanical big data boost the sustainable development of Chinese material medica agriculture. [ABSTRACT FROM AUTHOR]

• High level of genetic diversity was found in collected 266 pomegranate germplasms. • The germplasms were clustered into 4 subpopulations. • A representative core collection with 87 accessions was constructed. Pomegranate (Punica granatum L.) has a long cultivation history in China, and is well-loved for its unique flavor, health benefits, and beautiful symbol. However, handling redundant genetic information from a large number of germplasms is inefficient for breeding program of pomegranate, so it is necessary to construct a core set with minimal germplasm sampling and maximal genetic diversity. In this study, the genetic diversity and population structure of 266 collected pomegranate germplasms were analyzed using 40 SSR molecular markers with high polymorphism, and an integrated core collection was developed based on the genetic information. A total of 193 fragments were amplified in the 266 germplasms, ranging from 2 to 18 per marker, with an average allelic richness of 4.825. The polymorphic information content (PIC) value for each marker ranged from 0.225 to 0.744. The germplasms collected from Central China showed the highest genetic diversity (H o = 0.433, H e = 0.531, and I = 0.912), which might be related to the strong inclusiveness for germplasms and frequent gene exchange in this area. Population structure analysis showed that these germplasms were appointed into four subpopulations. Based on the SSR data, three core sets with 56, 50, and 53 germplasms were developed by Power Core (PC), Core Finder (CF), and Core Hunter (CH) programs, respectively. Because both PC and CF follow the M-strategy and CH follows the genetic distance sampling strategy, an integrated core collection with 87 germplasms combining germplasms in the core sets generated by PC and CH was further developed to maximize the genetic distances and genetic diversity parameters. This integrated core collection showed a high genetic diversity level (N a = 4.825, N e = 2.431, H o = 0.350, H e = 0.549, and I = 0.981), which were not significantly different from those of the initial collection, demonstrating sufficient representativeness for the initial collection. The development of the core collection with 87 germplasms is valuable to support the breeding program of pomegranates. [ABSTRACT FROM AUTHOR]

Carbapenem-resistant Klebsiella pneumoniae (CRKP) is emerging as a worldwide public health concern; however, molecular epidemiological surveillance of clinical CRKP bloodstream infection (BSI) in China is limited. We conducted a retrospective observational study to assess risk factors and the molecular epidemiology of CRKP BSI. We reviewed the medical records of enrolled patients to assess risk factors of CRKP BSI. Characteristics of CRKP isolates were analyzed by whole genome sequencing and Kleborate. Evolutionary diversification in CRKP isolates was described through Single Nucleotide Polymorphisms analysis and phylogenetic tree construction. We found that prior ICU hospitalization and use of carbapenems were independent risk factors for CRKP BSI. The main CRKP sequence type (ST) and capsular serotype were ST11 and KL64, and KPC-2 was the most prevalent enzyme type of carbapenemase-carrying Klebsiella pneumoniae. The most prevalent aerobactin and yersiniabactin of ST11-CRKP were iuc-1 and ybt9 ICEKp3, as for KL64-CRKP. Phylogenomic analysis showed that the antibacterial resistance genes on plasmids were highly consistent, but the genetic background of the chromosomes was still different. Our findings are important for hospitals, allowing them to limit dissemination of CRKP and optimize antibiotic administration. [ABSTRACT FROM AUTHOR]

A total of 1797 imported food samples collected during 2018 to 2020 were investigated for Listeria monocytogenes. Antibiotic susceptibility tests and whole genome sequencing analysis were performed for the obtained isolates. The overall prevalence of L. monocytogenes was 5.62 %; the highest prevalence was observed for pork (13.65 %), followed by fish (6.25 %), sheep casing (6.06 %), chicken (3.61 %), and beef (2.06 %). Geographical differences in prevalence were also observed for pork. Resistance to oxacillin (39.33 %) and clindamycin (16.85 %) was common, whereas resistance rates for other antibiotics were relatively low, ranging from 0 % to 6.74 %. Pork and fish isolates showed resistance to more antibiotics than beef isolates. Tetracycline and chloramphenicol resistance phenotypes strongly correlated with genotypes. The predominant serogroup was 1/2a, 3a, at 44.44 %, while the percentages of three other serogroups were similar and relatively lower, from 17.28 % to 19.75 %. Significant genetic differences were observed among lineage I and II isolates. LIPI-3 was carried by 19.75 % (16/81) of isolates and LIPI-4 by 6.17 % (5/81); all were lineage I. The stress survival island was present in 31.03 % (9/29) of lineage I and 83.02 % (44/53) of lineage II. Benzalkonium chloride tolerance genes were carried by 10.34 % (3/29) of lineage I and 23.08 % (12/52) of lineage II isolates. A total of 25 sequence types (STs) were identified, among which one was novel; ST9 and ST121 were the most prevalent. Disparate distribution of STs among food types was observed, and geographical and food related characteristics were also found for some STs. Hypervirulent STs, such as ST1, ST4 and ST6, belonged to 4b,4e,4e; carried LIPI-3 and/or LIPI-4; and some even were ECI or ECII; while only one carried SSI or BC tolerance genes. In contrast, hypo-virulent STs such as ST9 and ST121 carried SSI and BC tolerance genes, while none had LIPI-3/LIPI-4. Certain STs were detected frequently from a particular food of a particular country for a long time, indicating more attention should be given to these special persistent isolates. These findings are valuable for source tracking, prevention and control of L. monocytogenes in the global food chain. • Prevalence and antibiotic resistance of L. monocytogenes in food samples differed by geographical region and food type. • Virulence and stress tolerance gene differed among lineages and sequence types of L. monocytogenes. • Distinct traits were observed for L. monocytogenes isolates from a specific food/country. • Hypervirulent strains of L. monocytogenes were found. [ABSTRACT FROM AUTHOR]

Concentrating limited resources to protect as many species as possible is the most effective way to improve conservation efficiency, of which identifying the clustering characteristics of species in urgent need of conservation is a prerequisite. In this study, selectivity was used to characterize the taxonomic and geographic clustering characteristics of extinction risk for threatened spermatophytes in China. Results showed that the number of threatened species was highly clustered in taxonomy, floristic regions, and at the county scale. Clustering of threatened species was detected in 18 orders, 53 families, and 201 genera, account for 15.0 %–32.8 % of the total and 52.5 %–71.3 % of the threatened spermatophyte species. 18 out of 57 floristic regions and subregions were over-threatened. 298 counties (10.1 % of China's territory) were over-threatened, covering 83.4 %, 79.3 % and 80.3 % of the total species, threatened species and endemic species, respectively. Counties with the top 10.0 % species richness (SR), threatened species richness (TR) and endemic species richness (ER) covered 79.5 %, 70.3 % and 75.0 % of the total species, threatened species and endemic species, respectively, while covering only 5.7 % of the area of China. More than half of the counties with the top 10.0 % SR, TR and ER, as well as those over-threatened, were outside the existing conservation strategy and action plan. Areas most at risk were also found to be moderately affected by human influence (evaluated by human influence index (HII)) in China. This study provides a new perspective for the study of conservation priority in taxonomic groups and geographical areas. [ABSTRACT FROM AUTHOR]

Abstract: State and local governments in China have implemented a series of grassland protection policies to address the problem of grassland degradation. In 2003, Ningxia was the first province to implement a province-wide grazing ban. The effect of this ban is contentious at all levels of government and has become a topic of public concern. Grassland desertification is the most direct indicator of the effect of the grazing ban. We selected 14 counties and cities in north-central Ningxia as the study area. A desertification classification and grading system for Ningxia's grassland was then designed based on fieldwork and expert review. Using the Spectral Mixture Analysis (SMA) and decision-tree methods, we interpreted Landsat TM/ETM+ images of the study area during four years: 1993, 2000, 2006 and 2011. The following results were obtained: from 1993 to 2011, the area of desertified grassland in north-central Ningxia decreased gradually from 8702km2 in 1993 to 7485km2 in 2011, a decrease of 13.98%; the degree of desertification gradually decreased from 3573km2 of severely desertified grassland in 1993 to 1450km2 in 2011, a decrease of 59.41%; desertified grassland vegetation was restored rapidly during 2000–2006 and 2006–2011, reducing the total area of desertified grassland annually by 1.87 and 0.61%, respectively; finally, the area of severely desertified grassland decreased annually by 5.78 and 6.28% during 2000–2006 and 2006–2011, respectively. These results show that the region-wide grazing ban, together with other ecological engineering measures, has helped reverse desertification and promote the restoration of grassland vegetation. [Copyright &y& Elsevier]

Abstract: Ethnopharmacologica relevance: Picrasma quassiodes (D. Don) Benn. (PQB) is a widely used herbal medicine used for gastroenteritis, snakebite, infection and hypertension in China. The aim of the study was to investigate the possible antihypertensive mechanisms on spontaneously hypertensive rats (SHR) of the extract from Picrasma quassiodes (D. Don) Benn. Materials and methods: In the in vivo study, extract from Picrasma quassiodes (D. Don) Benn. at the dose of 50, 100, 200mg/kg and captopril (12.5mg/kg) were administrated to different group of SHR rats by gavage for six consecutive weeks after the blood pressures were firstly measured. At the end of the study, rats serum nitric oxide (NO) was measured by the nitrate reductase method; superoxide dismutase (SOD) and malondialdehyde (MDA) activities were measured by the colorimetric method; the expression of aorta endothelial nitric oxide synthase (eNOS) was measured by immunohistochemical analysis. Results: The results showed that the oral administration of PQB could lower the systolic blood pressure (SBP) of SHR rats. In addition, the serum level of NO in SHR treated with PQB (100 and 200mg/kg) was increased dramatically (P<0.05, P<0.01), but administration with captopril had no significant effect. The expression of aorta eNOS was markedly increased when treated with PQB. The serum SOD levels were increased with treatment of PQB (100 and 200mg/kg; P<0.05, P<0.01). All the effects of these parameters were comparable to that of the SHR control group. Conclusions: Our results disclosed that PQB is effective to lower blood pressure of SHR, its antihypertensive effect is probably associated with lowering oxidative stress by reducing SOD activity, preserving endothelial function and increasing the expression of eNOS to regulate NO and directly relax artery. [Copyright &y& Elsevier]

Abstract: Berberine, a compound isolated from Chinese Goldthread Rhizome, has been widely used as a non-prescription drug to treat diarrhoea in China. Previous studies have demonstrated multiple pharmacological activities for berberine, including its significant role in antimicrobial activity. However, its effect on ion exchange and water transfer remains unclear. The present study aims to explore the effect of berberine on the expression of Na+/H+ exchanger3 (NHE3) and aquaporin4 (AQP4) in both diarrhoea mouse model induced by sennosideA and human intestinal epithelium cell line (HIEC). Semi-quantitative RT-PCR, immunohistochemistry and western blotting were adopted to detect the mRNA and protein expression levels of NHE3 and AQP4. Furthermore, the absorption of berberine and the PKC activity were detected by HPLC and PepTag® Assay to elucidate the underlying mechanisms. It was shown that the expression levels of NHE3 and AQP4 were significantly increased in the diarrhoea mice treated with berberine compared with the untreated diarrhoea mice. Similarly, the expression levels of NHE3 and AQP4 were strikingly enhanced in HIEC co-treated with sennosideA and berberine compared with samples treated with sennosideA only. We also found the maximal absorption of berberine to be approximately 0.01%. In addition, no significant change of PKC activity was observed in the different HIEC treated groups. These results showed that berberine was able to increase the expression of NHE3 and AQP4, suggesting that berberine might exhibit its anti-diarrhoeal effect partially by enhancing the absorption of Na+ and water. [Copyright &y& Elsevier]

Abstract: Enterovirus 71 (EV 71) is one of the commonest causative agents of hand, foot, and mouth disease (HFMD), which infects mainly young children. It has been associated with severe neurological complications worldwide, and has caused significant deaths in many provinces of China from March to May 2008. In this study, RNA interference (RNAi) was used as an antiviral agent to inhibit EV 71 replication in rhabdomyosarcoma (RD) cells. Three small interfering RNAs (siRNAs) targeting extremely conserved regions among multiple EV 71 strains in China could effectively block the replication of EV 71 strain Shzh-98. Combination transfection of these three siRNAs could produce a strong inhibitory effect not only in strain Shzh-98, but also in one epidemic strain Fuyang-0805 isolated from a child in the city of Fuyang with a clinical diagnosis of HFMD in 2008. These strategies and results suggest that RNAi has potential therapeutic use for the suppression of EV 71 infection in a broad spectrum of viral strains. [Copyright &y& Elsevier]

Microbial communities play a very important role in soil ecological processes by regulating biogeochemical cycles during biological soil crust (BSC) succession in desert ecosystems. Although the relationships between microbial carbon or nitrogen and the BSC at different successional stages have been a source of great concern, there are few reports regarding the phosphorus (P) and sulfur (S) cycles. In this study, we used a functional gene array (GeoChip 5.0) to analyze the characteristics of microbial communities and their functional genes involved in the P and S cycles along a chronosequence of BSC succession in the Tengger Desert, China. The results showed that the functional genes associated with polyphosphate degradation and sulfite reduction were the major components involved in the P and S cycles, respectively, and the intensities of the functional genes expression involved in the P and S cycles increased significantly in 61-year-old BSCs. Compared with the fungal and archaeal communities, the bacterial community was the major contributor to the P and S cycles, and Proteobacteria (mainly Alphaproteobacteria, Gammaproteobacteria, and Betaproteobacteria) and Actinobacteria were the dominant phyla. A redundancy analysis showed that there was significant synergy between the improvement in soil properties (e.g., soil nutrient content) and the intensities of genes expression related to P and S cycles. These findings indicated that after 61 years, BSC significantly promoted the microbial metabolic potential for P and S cycling, which in turn promoted soil rehabilitation in a desertified dryland. • Polyphosphate degradation and sulfite reduction were the major metabolism processes involved in the P and S cycles in BSCs. • The intensity of gene expression involved in P and S cycles increased significantly in 61-year-old BSC. • Bacterial community was the major contributor to the P and S cycles of BSCs compared to fungi and archaea. [ABSTRACT FROM AUTHOR]

Background: For the past 20 years, twice-daily thoracic radiotherapy with concurrent chemotherapy has been the treatment of choice for limited-stage small-cell lung cancer (LS-SCLC), which has a poor prognosis. We aimed to assess the efficacy and safety of high-dose, accelerated, hyperfractionated, twice-daily thoracic radiotherapy (54 Gy in 30 fractions) versus standard-dose radiotherapy (45 Gy in 30 fractions) as a first-line treatment for LS-SCLC., Methods: This open-label, randomised, phase 3 trial was performed at 16 public hospitals in China. The key inclusion criteria were patients aged 18-70 years, with histologically or cytologically confirmed LS-SCLC, who had an Eastern Cooperative Oncology Group (ECOG) performance status of 0-1, and who were previously untreated or had received one course of cisplatin or carboplatin and etoposide. Eligible patients were randomly assigned (1:1) to receive volumetric-modulated arc radiotherapy (VMAT) of 45 Gy in 30 fractions to the gross tumour volume or VMAT with a simultaneous integrated boost of 54 Gy in 30 fractions to the gross tumour volume starting 0-42 days after the first chemotherapy course. Both groups received 10 fractions of twice-daily thoracic radiotherapy per week. The planning target volume was 45 Gy in 30 fractions in both groups. Patients with responsive disease received prophylactic cranial radiotherapy (25 Gy in 10 fractions). Randomisation was performed using a centralised interactive web response system, stratified by ECOG performance status, disease stage, previous chemotherapy course, and chemotherapy choice. The primary outcome was overall survival in the intention-to-treat population. Safety was analysed in the as-treated population. This study was registered at ClinicalTrials.gov, NCT03214003., Findings: From June 30, 2017, to April 6, 2021, 224 patients (102 [46%] females and 122 [54%] males; median age 64 years [IQR 58-68]) were enrolled and randomly assigned to the 54 Gy group (n=108) or 45 Gy (n=116) group. The median follow-up was 46 months (IQR 33-56). The median overall survival was significantly longer in the 54 Gy group (60·7 months [95% CI 49·2-62·0]) than in the 45 Gy group (39·5 months [27·5-51·4]; hazard ratio 0·55 [95% CI 0·37-0·72]; p=0·003). Treatment was tolerable, and the chemotherapy-related and radiotherapy-related toxicities were similar between the groups. The grade 3-4 radiotherapy toxicities were oesophagitis (14 [13%] of 108 patients in the 54 Gy group vs 14 [12%] of 116 patients in the 45 Gy group; p=0·84) and pneumonitis (five [5%] of 108 patients vs seven [6%] of 116 patients; p=0·663). Only one treatment-related death occurred in the 54 Gy group (myocardial infarction). The study was prematurely terminated by an independent data safety monitoring board on April 30, 2021, based on evidence of sufficient clinical benefit., Interpretation: Compared with standard-dose thoracic radiotherapy (45 Gy), high-dose radiotherapy (54 Gy) improved overall survival without increasing toxicity in a cohort of patients aged 18-70 years with LS-SCLC. Our results support the use of twice-daily accelerated thoracic radiotherapy (54 Gy) with concurrent chemotherapy as an alternative first-line LS-SCLC treatment option., Funding: Chinese Society of Clinical Oncology-Linghang Cancer Research, the Wu Jieping Medical Foundation, and Clinical Research Fund For Distinguished Young Scholars of Peking University Cancer Hospital and Beijing Municipal Administration of Hospitals Incubating Program., Competing Interests: Declaration of interests We declare no competing interests., (Copyright © 2024 Elsevier Ltd. All rights reserved, including those for text and data mining, AI training, and similar technologies.)

Understanding the variability of extinction risk and its potential drivers across different spatial extents is crucial to revealing the underlying processes of biodiversity loss and sustainability. However, in countries with high climatic and topographic heterogeneity, studies on extinction risk are often challenged by complexities associated with extent effects. Here, using 2.02 million fine-grained distribution records and a phylogeny including 27,185 species, we find that the extinction risk of flowering plants in China is spatially concentrated in southwestern China. Our analyses suggest that spatial extinction risks of flowering plants in China may be caused by multiple drivers and are extent dependent. Vegetation structure based on proportion of growth forms is likely the dominant extinction driver at the national extent, followed by climatic and evolutionary drivers. Finer extent analyses indicate that the potential dominant extinction drivers vary across zones and vegetation regions. Despite regional heterogeneity, we detect a geographical continuity potential in extinction drivers, with variation in West China dominated by vegetation structure, South China by climate, and North China by evolution. Our findings highlight that identification of potential extent-dependent drivers of extinction risk is crucial for targeted conservation practice in countries like China., (© 2024. The Author(s).)

Background: Many consumers use cosmetic eye products to counteract age-related changes in appearance. Measurements of eyelid shape in Asian women have been reported in the frontal view or 45-degree profile only. The aim of this study was to describe morphological characteristics of the upper eyelid in Japanese and Chinese females from the frontal and profile aspects and examine morphological changes with age., Materials and Methods: Standardized digital photographs of 772 Japanese and 346 Chinese women (15-79 years of age) were acquired in frontal and 90-degree profile aspects. Eleven upper eyelid parameters (e.g., width, length, depth, aperture, and curvature) were measured using image analysis to determine age-related changes and compare by ethnicity., Results: Eyelid width, area between eyebrow and eyelid, and eyelid curvature were comparable for both ethnicities under age 40, but the aging effect was more pronounced in Chinese subjects. Eyelid height, depth, and upper eyelid aperture angle were also comparable for both ethnicities under age 40, but the aging effect was more evident in Japanese subjects. Upper eyelid incline angle, eye orientation, and upper eyelid protrusion angle changed comparably with age for both ethnicities. No prominent age-related changes were evident for eyelid length or area between eyebrow and eye with the eye closed., Conclusion: Upper eyelid morphology changes with age in Japanese and Chinese females, starting around 40 years of age. Ethnic differences are limited in younger age groups but become more prominent with age. The findings suggest that aging affects some upper eyelid features earlier than others., (© 2024 NIHON L'ORÉAL K.K. Skin Research and Technology published by John Wiley & Sons Ltd.)

Background: The brachytherapy is an indispensable treatment for gynecological tumors, but the quality and efficiency of brachytherapy training for residents is still unclear., Methods: An anonymous questionnaire was designed to collect information on gynecological brachytherapy (GBT) training for radiation oncology residents from 28 training bases in China. The questionnaire content was designed based on the principle of competency based medical education (CBME). The Likert scale was employed to evaluate self-reported competence and comprehension regarding GBT. A total of 132 senior residents were included in the final analysis., Results: 53.79% (71/132) of senior residents had experience in performing image-guided GBT, whereas 76.52% (101/132) had observed the procedure during their standardized residency training. The proportion of senior residents who reported having the self-reported competence to independently complete the GBT was 78.03% for intracavity GBT, 75.00% for vaginal stump GBT, and 50.03% for interstitial GBT, respectively. The number of successful completion of Interstitial, intracavity and vaginal GBT was correlated with the self- confidence of trainees after standardized training. In particular, the independent completion of interstitial GBT for more than 20 cases was an independent factor for the self-reported competence of senior residents. During the training period, 50.76% and 56.82% of the residents had not participated in the specialized examinations and professional GBT courses., Conclusions: The study revealed that the self-confidence of residents to independently complete brachytherapy was relatively high, and the specialized curriculum setting and training process assessment for brachytherapy training still need to be strengthened in the future., (© 2024. The Author(s).)

Objective: The consistency of bladder volume is very important in pelvic tumor radiotherapy, and portable bladder scanner is a promising device to measure bladder volume. The purpose of this study was to investigate whether the bladder volume of patients with pelvic tumor treated with radiotherapy can be accurately measured using the Meike Palm Bladder Scanner PBSV3.2 manufactured in China and the accuracy of its measurement under different influencing factors., Methods: A total of 165 patients with pelvic tumor undergoing radiotherapy were prospectively collected. The bladder volume was measured with PBSV3.2 before simulated localization. CT simulated localization was performed when the bladder volume was 200-400ml. The bladder volume was measured with PBSV3.2 immediately after localization and recorded. The bladder volume was then delineated on CT simulation images and recorded. To compare the consistency of CT simulation bladder volume and bladder volume measured by PBSV3.2. To investigate the accuracy of PBSV3.2 in different sex, age, treatment purpose, and bladder volume., Results: There was a significant positive correlation with bladder volume on CT and PBSV3.2 (r = 0.874; p < 0.001). The mean difference between CT measured values and PBSV3.2 was (-0.14 ± 50.17) ml. The results of the different variables showed that the overall mean of PBSV3.2 and CT measurements were statistically different in the age ≥ 65 years, bladder volumes > 400ml and ≤ 400ml groups (p = 0.028, 0.002, 0.001). There was no statistical significance between the remaining variables. The volume difference between PBSV3.2 measurement and CT was 12.87ml in male patients, which was larger than that in female patients 3.27ml. Pearson correlation analysis showed that the correlation coefficient was 0.473 for bladder volume greater than 400ml and 0.868 for bladder volume less than 400ml; the correlation coefficient of the other variables ranged from 0.802 to 0.893., Conclusion: This is the first large-sample study to evaluate the accuracy of PBSV3.2 in a pelvic tumor radiotherapy population using the convenient bladder scanner PBSV3.2 made in China. PBSV3.2 provides an acceptable indicator for monitoring bladder volume in patients with pelvic radiotherapy. It is recommended to monitor bladder volume with PBSV3.2 when the planned bladder volume is 200-400ml. For male and patients ≥ 65 years old, at least two repeat measurements are required when using a bladder scanner and the volume should be corrected by using a modified feature to improve bladder volume consistency., (© 2023. The Author(s).)

The pneumonia caused by novel coronavirus SARS-CoV-2 infection in early December 2019, which was later named coronavirus disease 2019 (COVID-19) by the World Health Organization (WHO), rapidly spread across the world. China has made extraordinary efforts to this unprecedented pandemic, put its response and control at a very high level of infectious disease management (Category B but with measures for Category A), given top priority to the people and their lives, and balanced the pandemic control and socio-economic development. After more than three years' fighting against this disease, China downgraded the management of COVID-19 to Category B infectious disease on January 8, 2023 and the WHO declared the end of public health emergency on May 5, 2023. However, the ending of pandemic does not mean that the disease is no longer a health threat. Experiences against COVID-19 from China and the whole world should be learned to prepare well for the future public health emergencies. This article gives a systematic review of the trajectory of COVID-19 development in China, summarizes the critical policy arrangements and provides evidence for the adjustment during policy making process, so as to share experiences with international community and contribute to the global health for all humanity., (© 2024. Higher Education Press.)

Objectives: The role of induction chemotherapy (IC) remains ambiguous in a patient with T3-4N0-1 nasopharyngeal carcinoma (NPC) according to data from the endemic area of China. Here, we conducted a multicenter retrospective study to investigate the value of adding IC to concurrent chemoradiotherapy (CCRT) for T3-4N0-1 NPC from Northwest China., Methods: Data were extracted in 3 hospitals from Northwest China between May 1, 2010 and August 30, 2018. The Kaplan-Meier method was used to estimate the endpoints. Survival curves were compared using the log-rank test. Initial propensity matching was conducted with a 1:1 match of IC + CCRT to CCRT. The primary endpoint of this study was overall survival (OS)., Results: A total of 108 patients with staging T3-4N0-1 were included in this study. The median follow-up time was 50 months (range: 6 to 118 months). IC followed by CCRT did not significantly improve OS compared with CCRT in the whole cohort (89.5% vs 77.6%, hazard ratio: 0.41, 95% CI: 0.16-1.04, P = 0.100). But significantly better OS was found when a well-balanced propensity score-matched cohort was analyzed. Adjusted 4-year OS was 89.5% for IC followed by CCRT versus 71.1% for CCRT (hazard ratio: 0.30, 95% CI: 0.11-0.80, P = 0.027). No significant differences were detected in side effects between the two groups., Conclusion: This study suggested IC followed by CCRT had the potential to further improve OS in patients with T3-4N0-1M0 NPC from Northwest China compared with CCRT. However, prospective studies with a large sample are warranted to confirm the results., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)

Background: Recently, the emergence of carbapenem-resistant hypermucoviscous Klebsiella pneumoniae has aroused increasing attention in China. We investigated the characteristics of a Klebsiella pneumoniae carbapenemase-2 (KPC-2) and New Delhi metallo-β-lactamase-5 (NDM-5) coproducing hypermucoviscous K. pneumoniae strain, named RJ-8061, which was isolated from the urine of an 86-year-old female patient with pneumonia. Methods: The RJ-8061 strain was investigated by string test, antimicrobial susceptibility testing, polymerase chain reaction for carbapenemase genes detection, capsular genotyping, multilocus sequence typing, whole-genome sequencing, and phylogenetics. A serum killing assay and a Galleria mellonella infection model were used to evaluate the virulence of RJ-8061 in vitro and in vivo . Results: RJ-8061 belonged to the sequence type 11 K64 serotype and showed high-level resistance to almost all frequently used antibiotics, only remaining susceptible to amikacin, colistin, and tigecycline. The complete genome size of RJ-8061 was 6,106,028 bp, including a 5,394,921 bp chromosome and seven circular plasmids. Plasmid pRJ-8061-hybrid is a 294,249 bp hybrid plasmid that co-harbored resistance genes [ bla TEM-1B , mph(A) , aac(3)-IId ] and virulence genes ( iucABCDiutA , rmpA2 ), whereas rmpA2 is a truncated version. In addition, bla KPC-2 and bla NDM-5 were located on plasmids 171,321 bp pRJ-8061-KPC-2 (IncFII/IncR) and 46,161 bp pRJ-8061-NDM-5 (IncX3), respectively. K-mer-based phylogenetic analysis grouped RJ-8061 into a carbapenem-resistant Klebsiella pneumoniae cluster. The G. mellonella infection model revealed that RJ-8061 showed relatively low virulence, with a 50% lethal dose of 10 6 cfu. Conclusions: To the best of our knowledge, this is the first report of a hypermucoviscous K. pneumoniae coproducing KPC-2 and NDM-5 carbapenemases.

Autosomal recessive congenital ichthyosis (ARCI) is a heterogeneous group of rare cornification disorders. Of the 14 genes already known to cause ARCI, CYP4F22 is a relatively new genetic etiology, the mutation spectrum of which has yet to be profiled. Using whole-exome sequencing in family trios, we identified the compound heterozygous mutations, c.844C>T (p.R282W) and c.1189C>T (p.R397C), of the CYP4F22 gene (NM&#95;173483.4) in a Chinese neonatal boy with a congenital ichthyosis phenotype. In combination with multiple in silico analyses and the following in vitro functional studies, we provided evidence to classify these two variations as pathogenic mutations and demonstrated that both variants significantly reduced the CYP4F22 protein amount. Interestingly, the reduction of both mutant CYP4F22 protein could be recovered by trichostatin A (TSA) treatment, suggesting some deacetylation factors involved in regulating the mutant CYP4F22 protein and implying TSA might be a potential candidate compound for congenital ichthyosis caused by CYP4F22 variations., (© 2022 Japanese Dermatological Association.)

Rationale: Hepatitis B x protein (HBx) is required to initiate and maintain the replication of hepatitis B virus (HBV). Protein arginine methyltransferases 5 (PRMT5) negatively regulates HBV transcription. WD repeat domain 77 protein (WDR77) greatly enhances the methyltransferase activity of PRMT5. However, the role of WDR77 in the modulation of cccDNA transcription and HBV replication is poorly understood. In this study, we investigated the mechanism by which HBx modulated HBV replication involving WDR77 in the liver. Methods: A human liver-chimeric mouse model was established. Immunohistochemistry (IHC) staining, Western blot analysis, Southern blot analysis, Northern blot analysis, immunofluorescence assays, ELISA, RT-qPCR, CoIP assays, and ChIP assays were performed in human liver-chimeric mouse model, primary human hepatocytes (PHHs), HepG2-NTCP, dHepaRG and HepG2 cell lines. Results: HBV infection and HBx expression remarkably reduced the protein levels of WDR77 in human liver-chimeric mice and HepG2-NTCP cells. WDR77 restricted cccDNA transcription and HBV replication in PHHs and HepG2-NTCP cells. Mechanically, WDR77 enhanced PRMT5-triggered symmetric dimethylation of arginine 3 on H4 (H4R3me2s) on the cccDNA minichromosome to control cccDNA transcription. HBx drove the cellular DDB1-containing E3 ubiquitin ligase to degrade WDR77 through recruiting WDR77, leading to the disability of methyltransferase activity of PRMT5. Thus, HBx promoted HBV replication by driving a positive feedback loop of HBx-DDB1/WDR77/PRMT5/H4R3me2s/cccDNA/HBV/HBx in the liver. Conclusions: HBx attenuates the WDR77-mediated HBV repression by driving DDB1-induced WDR77 degradation in the liver. Our finding provides new insights into the mechanism by which HBx enhances HBV replication in the liver., Competing Interests: Competing Interests: The authors have declared that no competing interest exists., (© The author(s).)

Background: Due to strict, nationwide, comprehensive COVID-19 protective measures, including home quarantine, all Chinese medical students began taking web-based classes beginning in the spring semester of 2020. Home quarantine, web-based classes, and the stress surrounding the COVID-19 pandemic may have triggered an increased incidence of mental health problems among medical students. Although there have been increasing amounts of literature on depression among medical students, studies focusing on positive psychological resources, such as resilience during the COVID-19 pandemic, still need to be expanded., Objective: This study aims to assess depression among medical students who are taking web-based classes during the COVID-19 pandemic and to investigate the role of coping styles as mediators between resilience and depression., Methods: A cross-sectional study of 666 medical students involving stratified sampling in Shenyang, Liaoning Province, China, was completed between March 20 and April 10, 2020. The participants responded to a self-administered, smartphone-based questionnaire, which included the Patient Health Questionnaire-9, Simplified Coping Style Questionnaire, and Ego Resilience 89 Scale. Hierarchical linear regression and structural equation modeling were used in this study., Results: The prevalence of depression among the participants was 9.6% (64/666) in this study. The regression analysis revealed that grade (the year in which the medical student was in training) (P=.013), how well students adapted to web-based classes (P<.001), their levels of resilience (P=.04), and their coping styles were independent predictors for depression (P<.001). Resilience and positive coping styles were negatively related to depression (resilience: P=.04; positive coping styles: P<.001), and negative coping styles were positively related to depression (P<.001). The structural equation modeling analysis showed that the effect of resilience on depression was partially mediated by coping styles (P=.007)., Conclusions: In this study, it was found that the prevalence of depression was slightly low and coping styles mediated the association between resilience and depression among medical students during the COVID-19 pandemic. These findings have significant implications for future studies. Future studies and interventions should aim to improve resilience and promote positive coping styles., (©Lina Zhao, Kristin Sznajder, Dan Cheng, Shimeng Wang, Can Cui, Xiaoshi Yang. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 07.06.2021.)

Delivery mode is recognized as an important determinant of gut microbiota composition. Vaginally delivered infants were colonized by maternal vaginal and fecal microbiota, while those delivered by cesarean section were colonized by environmental microorganisms. To reveal differences induced by delivery mode, we determined fecal microbiota and fecal metabolome from 60 infants in Northeast China region. Bacterial gene sequence analysis showed that the feces of vaginally delivered infants had the highest abundance of Bifidobacterium, Lactobacillus, Bacteroides and Parabacteroides, while the feces of cesarean section delivered infants were more enriched in Klebsiella. LC-MS-based metabolomics data demonstrated that the feces of vaginally delivered infants were associated with high abundance of DL-norvaline and DL-citrulline, while the feces of cesarean section delivered infants were abundant in trans-vaccenic acid and cis-aconitic acid. Moreover, the feces of vaginally delivered infants was significantly in positive correlation with tryptophan metabolism and pyruvate metabolism, however, the feces of cesarean section delivered infants was positively correlated with ABC transporters. Collectively, our study demonstrated that gut microbiota and metabolite profiles were significantly different between vaginally delivered and cesarean section delivered infants, and provided the theoretical basis for restoring the intestinal environment of cesarean section infants birthed in the study region. SIGNIFICANCE: The intestinal microbiota and metabolites play important roles in infant development. To validate whether delivery modes influence the gut environment, we performed a detailed analysis of the earliest microbial colonization of the infant gut using a combination of 16S rRNA gene amplicon sequencing and LC-MS-based metabolomics. We found that the gut microbiota and metabolite composition were significantly different between vaginally delivered infants and cesarean section delivered infants. Our findings establish a vital baseline for studies tracking the infant gut microbiota and metabolite development following different delivery modes, and their associated effects on infant health. This study provides preliminary evidence that the observed differences due to delivery modes highlight their importance in shaping the early intestinal microbiota and metabolites., (Copyright © 2020. Published by Elsevier B.V.)

The purpose of this study is to observe the potential of lung ultrasound in evaluating the severity of coronavirus disease 2019 (COVID-19) pneumonia. Lung ultrasound was performed in ten zones of the patients' chest walls. The features of the ultrasound images were observed, and a lung ultrasound score (LUS) was recorded. The ultrasound features and scores were compared between the refractory group (PaO 2 /FiO 2 ≤ 100 mm Hg or on extracorporeal membrane oxygenation) and the non-refractory group. The prediction value of the LUS was studied by receiver operating characteristic (ROC) curve analysis. In total, 7 patients were enrolled in the refractory group and 28 in the non-refractory group. B-line patterns and shred signs were the most common signs in all patients. Patients in the refractory group had significantly more ground-glass signs (median 6 [interquartile range {IQR}, 2.5-6.5] vs. median 0 [IQR, 0-3]), consolidation signs (median 1 [IQR, 1-1.5] vs. median 0 [IQR, 0-3]) and pleural effusions (median 5 [IQR, 1.5-6] vs. median 0 [IQR, 0-0.25]). The LUS was significantly higher in the refractory group (33.00 [IQR 27.50-34.00] vs. 25.50 [IQR 22.75-30.00]). The ROC of the LUS showed a cutoff score of 32 with a specificity of 0.893 and a sensitivity of 0.571 in diagnosing refractory respiratory failure among patients. In COVID-19 patients, lung ultrasound is a promising diagnostic tool in diagnosing patients with refractory pneumonia., (Copyright © 2020 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.)

We aimed to evaluate the effects of the COVID-19 lock down on lifestyle in China during the initial stage of the pandemic. A questionnaire was distributed to Chinese adults living in 31 provinces of China via the internet using a snowball sampling strategy. Information on 7-day physical activity recall, screen time, and emotional state were collected between January 24 and February 2, 2020. ANOVA, χ² test, and Spearman's correlation coefficients were used for statistical analysis. 12,107 participants aged 18-80 years were included. During the initial phase of the COVID-19 outbreak, nearly 60% of Chinese adults had inadequate physical activity (95% CI 56.6%-58.3%), which was more than twice the global prevalence (27.5%, 25.0%-32.2%). Their mean screen time was more than 4 hours per day while staying at home (261.3 ± 189.8 min per day), and the longest screen time was found in young adults (305.6 ± 217.5 min per day). We found a positive and significant correlation between provincial proportions of confirmed COVID-19 cases and negative affect scores (r = 0.501, p = 0.004). Individuals with vigorous physical activity appeared to have a better emotional state and less screen time than those with light physical activity. During this nationwide lockdown, more than half of Chinese adults temporarily adopted a sedentary lifestyle with insufficient physical activity, more screen time, and poor emotional state, which may carry considerable health risks. Promotion of home-based self-exercise can potentially help improve health and wellness.

Introduction: The PSENs/APP mutation distribution in Chinese patients with familial Alzheimer's disease (FAD) remains unclear. We aimed to analyze the genetic features of Chinese FAD pedigrees with and without PSENs/APP mutations., Methods: In total, 1330 patients with Alzheimer's disease (AD) or mild cognitive impairment in 404 pedigrees were enrolled from the Chinese Familial Alzheimer's Disease Network. PSENs/APP mutations and APOE frequencies were determined., Results: In total, 13.12% of pedigrees carried PSENs/APP missense mutations, 3.71% carried PSENs/APP synonymous/untranslated region variants, and 83.17% did not carry PSENs/APP mutations. Eleven missense mutations were first identified. In patients without PSENs/APP mutations, 44.31% carried one APOEε4 allele, and 14.85% two APOEε4 alleles., Discussion: The new PSENs/APP mutations indicate heterogeneity in AD pathogenesis between Chinese and other ethnic groups. The low mutation rate suggests the involvement of other genes/factors in Chinese FAD. APOEε4 might be a major gene for some FAD without PSENs/APP mutations., (© 2020 the Alzheimer's Association.)

Objective: To evaluate the prognostic value of ultrasonographic measurement of optic nerve sheath diameter (ONSD) and ONSD/eyeball transverse diameter (ETD) ratio in stroke patients during hospitalization., Methods: Adult patients with stroke (ischemic stroke or hemorrhagic stroke) admitted to department of critical care medicine of Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine from November 2017 to November 2018 were enrolled. On the day of admission, ONSD and ETD (retina-retina at 3 mm behind the globe along) were detected by ultrasound, the ONSD/ETD ratio was calculated, and the baseline data and outcomes were recorded. Patients were divided into survival group and death group according to their survival status. Locally weighted scatterplot smoothing (LOWESS) and the receiver operating characteristic (ROC) curve were used to calculate the thresholds of ONSD and ONSD/ETD. The correlation between ONSD, ONSD/ETD and prognosis were assessed., Results: Thirty-eight of 83 patients (45.8%) survived and were discharged from the hospital, while 45 patients died (54.2%). There were significant differences in Glasgow coma score (GCS), shifting of the middle structure, ONSD and ONSD/ETD between the death group and the survival group [GCS: 4.7±2.8 vs. 11.0±3.2, shifting of the middle structure (mm): 5.8±5.9 vs. 1.3±2.6, ONSD (mm): 5.5±0.4 vs. 4.4±0.5, ONSD/ETD: 0.25±0.02 vs. 0.20±0.02, all P < 0.05]. LOWESS and ROC curve analysis suggested thresholds of ONSD and ONSD/ETD for predicting adverse prognosis of stroke patients were 5.0 mm and 0.25, respectively. By adjusting the influence of confounding factors on prognosis, a prediction model based on ONSD was established, and the ROC curve was drawn. The area under the curve (AUC) was 0.978, the optimal predictive point of the model was 0.870, the sensitivity was 89%, and the specificity was 100%. The ONSD/ETD prediction model was also obtained, and the AUC was 0.988, the optimal prediction threshold of the model was 0.768, and the sensitivity for predicting adverse clinical prognosis was 94%, and the specificity was 97%. The stability of ONSD/ETD was better than that of ONSD. ONSD coefficient of variation was 0.14, and ONSD/ETD coefficient of variation was 0.13., Conclusions: ONSD and ONSD/ETD were significantly correlated with the prognosis of critical patients with stroke. The mortality increased significantly in patients with an ONSD greater than 5.0 mm and ONSD/ETD greater than 0.25. ONSD and ONSD/ETD may be promising tools for early assessment of clinical outcomes in these patients.

Background: Accurate forecast of the death risk is crucial to the administration of people living with HIV/AIDS (PLHIV). We aimed to establish and validate an effective prognosis nomogram in PLHIV receiving antiretroviral therapy (ART)., Methods: All the data were obtained from 2006 to 2018 in the Wenzhou area from China AIDS prevention and control information system. Factors included in the nomogram were determined by univariate and multiple Cox proportional hazard analysis based on the training set. The receiver operating characteristic (ROC) and calibration curves were used to assess its predictive accuracy and discriminative ability. Its clinical utility was also evaluated using decision curve analysis (DCA), X-tile analysis and Kaplan-Meier curve, respectively in an independent validation set., Findings: Independent prognostic factors including haemoglobin, viral load and CD4+ T-cell count were determined and contained in the nomogram. Good agreement between the prediction by nomogram and actual observation could be detected in the calibration curve for mortality, especially in the first year. In the training cohort, AUC (95% CI) and C-index (95% CI) were 0.93 (0.90, 0.96) and 0.90 (0.85, 0.96), respectively. In the validation set, the nomogram still revealed excellent discriminations [AUC (95% CI): 0.95 (0.91, 1.00)] and good calibration [C-index (95% CI): 0.92 (0.82-1.00)]. Moreover, DCA also demonstrated that the nomogram was clinical beneficial. Additionally, participants could be classified into three distinct (low, middle and high) risk groups by the nomogram., Interpretation: The nomogram presents accurate and favourable prognostic prediction for PLHIV who underwent ART., Funding: This work was supported by Zhejiang Basic Public Welfare Research Project (LGF19H260011), Wenzhou Basic Public Welfare Research Project (Y20180201), the Initial Scientific Research Fund (KYQD170301), the Major Project of the Eye Hospital Wenzhou the Major Project of the Eye Hospital Wenzhou Medical University (YNZD201602). Part of this work was also funded by National Natural Science Foundation of China (81670777) and Science and Technology Innovation Activity Plan and New Talents Plan for College Students in Zhejiang Province (2019R413073). The funders had no roles in study design, data collection, data analysis, interpretation and writing of the report., (Copyright © 2019. Published by Elsevier B.V.)